title: Patellar resurfacing versus no resurfacing in two-stage revision of infected total knee arthroplasty.
abstract: BACKGROUND
  Cartilage debridement and staged reimplantation are the most common treatments for infected total knee arthroplasty (TKA). Very few studies have focused on the management of primarily non-resurfaced patellae in infected TKA. The purpose of this study was to compare the outcomes of patellar resurfacing and non-resurfacing in two-stage revision of infected TKA.
  
  
  METHODS
  This study involved a retrospective comparison of the reinfection rate and clinical outcomes of revision TKA patients managed with patellar resurfacing (22 patients, 23 knees) and patients managed without patellar resurfacing (26 patients) at a minimum two-year follow-up. The mean age in the resurfacing group was 69.4years old, and the mean age in the non-resurfacing group was 67.3years old. Three scales were used in the assessment: the Knee Society Score, Western Ontario and McMaster Universities Osteoarthritis Index, and the Anterior Knee Pain Scale.
  
  
  RESULTS
  Three knees had recurrent infections. All infections occurred in patients who had received patellar resurfacing. There were no significant differences between groups in clinical results and on the Anterior Knee Pain Scale. A lack of patellar resurfacing did not increase recurrence of infection and did not result in significant clinical differences compared to patellar resurfacing.
  
  
  CONCLUSIONS
  This study indicates that preservation of the original patellar bone is a feasible option for patellar management in revision of septic TKA.
  
  
  METHODS
  Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
authors.affiliation: Joint & Arthritis Research, Department of Orthopaedic Surgery, Himchan Hospital, Seoul, Republic of Korea.
authors.forename: Jong-Hwan
authors.initials: JH
authors.lastname: Joo
authors.forename: Su-Chan
authors.initials: SC
authors.lastname: Lee
authors.forename: Nong-Kyoum
authors.initials: NK
authors.lastname: Ahn
authors.forename: Hye-Sun
authors.initials: HS
authors.lastname: Ahn
authors.forename: Kwang-Am
authors.initials: KA
authors.lastname: Jung
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000379:methods; D015331:Cohort Studies; D003646:Debridement / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010147:Pain Measurement; D010329:Patella / Q000503:physiopathology / Q000601:surgery*; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D012044:Regression Analysis; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors
keywords: Infection; Patellar non-resurfacing; Patellar resurfacing; Total knee arthroplasty